Is the BRAF(V600E) mutation useful as a predictor of preoperative risk in papillary thyroid cancer?

Am J Surg. 2012 Apr;203(4):436-41. doi: 10.1016/j.amjsurg.2011.02.013. Epub 2011 Jul 30.

Abstract

Objective: Recent studies have shown that a BRAF(V600E) reflects poor prognosis, mainly in Western countries. However, some clinicians in Japan have suggested that the BRAF(V600E) mutation is not associated with a poor prognosis. Therefore, we investigated a relationship between BRAF(V600E) mutation and clinicopathologic factors.

Methods: From September 2008 to December 2009, we performed routine analysis of the BRAF(V600E) mutation using thyroid cancer tissue from 424 patients who underwent thyroidectomy with cervical lymph node dissection.

Results: The BRAF(V600E) mutation was found in 335 of 424 cases (79%) and was higher in classic papillary thyroid carcinoma (PTC) (79.7%) than in the follicular variant of PTC (62.5%) (P = .019). On univariate analysis, the BRAF(V600E) mutation was associated with extrathyroidal extension (P = .009) and variants of PTC (P = .019), but a high-risk Metastasis, Patient Age, Completeness of resection, local Invasion and Tumor Size (MACIS) score (≥ 6) (P = .146) and lymph node metastasis (P = .628) were not significantly associated with the BRAF(V600E) mutation. Multivariate analysis showed that extrathyroidal extension is independently associated with the BRAF(V600E) mutation (relative ratio: 2.466; 95% confidence interval, 1.213-5.011; P < .013).

Conclusion: It is not clear that the BRAF(V600E) mutation is useful for prediction of poor prognosis of PTC.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Biopsy, Needle
  • Carcinoma
  • Carcinoma, Papillary
  • Cohort Studies
  • Female
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Korea
  • Lymph Nodes / pathology*
  • Lymph Nodes / surgery
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Point Mutation*
  • Predictive Value of Tests
  • Preoperative Care / methods
  • Prognosis
  • Proportional Hazards Models
  • Proto-Oncogene Proteins B-raf / genetics*
  • Proto-Oncogene Proteins B-raf / metabolism
  • Sensitivity and Specificity
  • Thyroid Cancer, Papillary
  • Thyroid Neoplasms / genetics*
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / surgery
  • Thyroidectomy / methods
  • Treatment Outcome
  • Young Adult

Substances

  • BRAF protein, human
  • Proto-Oncogene Proteins B-raf